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Individual

ADI K KHALSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RBT

Contact information

Practice address
3443 LILLY RD NE STE B, OLYMPIA, WA 98506-3091
(360) 456-2237
Mailing address
1815 LEGION WAY SE, OLYMPIA, WA 98501-1843
(360) 561-8162

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
00000000000
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000000000
RBT
WA
Enumeration date
12/28/2017
Last updated
12/28/2017
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